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Benefits Advising

32 Ways Your Pharmacy Benefits Manager (PBM) is Hiding Revenue

Pharmacy benefit managers (PBM’s) have 32 ways to hide revenue….

How many are they using to inflate your company’s health care costs? The typical math looks something like this: Prescription drugs makes up 30% of your overall health care spend (and, they are on track to represent 50% in the next few years).

The 32 hidden revenue sources make up 30-50% of that number. If you can eliminate this through transparency, this represents an opportunity to cut 10-15% out of your health plan cost.

Sadly, 76% of the prescriptions that flow to health plans around the country are administered by one of the big 3 traditional PBM’S (who invented the 32 ways).

Fortunately, that means 24% of the market has figured out how to fix this problem.

If you are purchasing your health plan from a retail insurance company/a large HMO – you are in the 76%. If you are in a self-funded arrangement that is administered by one of the large national health insurance carriers (also called an ASO plan) – you are also in the 76%.

The good news? You too can join the growing list of companies in the 24%.

If you are ready for fresh ideas when it come to your company’s health care spending let’s set up an introduction.

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